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目的:为临床合理使用抗菌药物治疗铜绿假单胞菌(PA)感染提供参考。方法:回顾性分析我院2011-2015年PA的耐药率,并统计10种临床常用抗菌药物的使用强度(AUD),采用Spearman相关性分析考察两者的相关性。结果:我院2011-2014年共检出PA 1 011株,其各年度检出率均位列前5位;抗菌药物AUD排序前3位的为左氧氟沙星、头孢他啶和头孢哌酮钠他唑巴坦钠。哌拉西林钠他唑巴坦钠、左氧氟沙星、环丙沙星和美罗培南的AUD与PA耐药率呈正相关(r分别为1.000、0.900、1.000和1.000,P<0.05),头孢哌酮钠他唑巴坦钠的AUD与PA耐药率呈负相关(r=-0.900,P<0.05),亚胺培南西司他丁钠、头孢他啶、庆大霉素、氨曲南和阿米卡星的AUD与PA耐药率无相关性(P>0.05)。结论:抗菌药物AUD与PA耐药率之间存在一定的相关性,定期检测PA耐药率和抗菌药物的使用情况对临床治疗具有重要意义。临床应综合考虑细菌监测数据、药敏试验结果、抗菌药物使用量与耐药率的相关性等因素,慎重选择抗菌药物,以减少耐药PA的产生。
OBJECTIVE: To provide reference for rational use of antibiotics to treat Pseudomonas aeruginosa (PA) infection in the clinic. METHODS: Resistant rate of PA in our hospital during 2011-2015 were analyzed retrospectively. Antibiotics use density (AUD) of 10 commonly used antibiotics were analyzed statistically, and the correlation of resistant rate with AUD was investigated by Spearman correlation analysis. RESULTS: One thousaud and eleven strains of PA were isolated in our hospital during 2011-2014, detection rate of PA always occupied the top 5 place. Top 3 antibiotics in the list of AUD were levofloxacin, ceftazidime, cefoperazone sodium and tazobactam sodium. AUD of piperacillin sodium and tazobactam sodium, levofloxacin, ciprofloxacin and meropenem were positively correlated with resistant rate of PA (r were 1.000, 0.900, 1.000, 1.000, P<0.05). AUD of cefoperazone sodium and tazobactam sodium were negatively correlated with resistant rate of PA (r=-0.900,P<0.05). AUD of imipenem and cilastatin sodium, ceftazidime, gentamicin, aztreonam and amikacin had no correlation with resistant rate of PA (P>0.05). CONCLUSIONS: There is correlation between AUD of antibiotics and resistant rate of PA. It is of important significance to detect resistant rate of PA and the use of antibiotics regularly. Antibiotics should be selected cautiously in accordance with bacterial monitoring data, results of drug sensitivity tests, the amount and resistant rate of antibiotics, etc, in order to reduce resistant PA.
铜绿假单胞菌耐药性抗菌药物使用强度相关性
Pseudomonas aeruginosaDrug resistanceAntibioticsAntibiotics use densityCorrelation
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